Amanda's Mini Day Spa

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

001010642 Issued in IL

Legal business name

AMANDA'S MINI DAY SPA

Practice address

510 E Chain of Rocks Rd
Granite City, IL 62040-2803

Phone

(314) 467-0766

NPI assigned

Jan 12, 2015

Last updated

Jan 12, 2015By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Amanda Mitchell, LMT

Title

Massage Therapist

Phone

(618) 531-7325

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Amanda Mitchell Other name

Tax ID family

Amanda Mitchell2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Amandas Mini Day Spa

  • Skilled Nursing Facility
  • Granite City, IL
  • NPI 1760870224
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1421020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421020800000",
    "number": "1750770988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 E CHAIN OF ROCKS RD",
            "city": "GRANITE CITY",
            "state": "IL",
            "postal_code": "620402803",
            "telephone_number": "314-467-0766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 E CHAIN OF ROCKS RD",
            "city": "GRANITE CITY",
            "state": "IL",
            "postal_code": "620402803",
            "telephone_number": "314-467-0766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMANDA'S MINI DAY SPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-12",
        "last_updated": "2015-01-12",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "MASSAGE THERAPIST",
        "authorized_official_telephone_number": "618-531-7325",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "IL",
            "license": "001010642",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASSAGE THERAPIST",
            "identifier": "001010642",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Amanda Mitchell",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Ahs Il Medical Group LLC (Gateway Medical Group/ILSW Orthopedics)
• Ahs Il Medical Group LLC
• Oladele O. Ajao, MD
• Cynthia Jeffries Akeman
• Alcoholic Rehabilitation Community Home
• Amandas Mini Day Spa
• Amar Medical Associates, PC
• American Healthcare Systems Illinois LLC (Gateway Regional Medical Center)
• American Healthcare Systems Illinois LLC
• Edward Carl Anderson, PA

• Physical Therapy Clinic/Center in Granite City, IL
• Providers in Granite City, IL by specialty
• Physical Therapy Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.